Patient-based outcomes after clubfoot surgery

Despite decades of experience in the area of clubfoot repair, considerable uncertainty remains regarding indications, surgical technique, and long-ter m results of treatment. Much of this uncertainty is due to the lack of a st andardized and valid method for assessing postoperative outcomes of clubfoo t repair. The current study used various end points to compare traditional and patient-based outcome measures and to develop a disease-specific instru ment that is both meaningful to the patient and statistically valid. A coho rt of 46 patients was identified, and several types of outcomes data were c ollected, including traditional end points of outcome (range of motion and radiographic criteria, qualitative patient-based data) and a previously val idated instrument measuring pediatric functional status (FSIIr). At an aver age follow-up of 45 months, radiographic measures and range of motion were comparable to values published in previous studies. Postoperative functiona l status, as measured by the FSIIr, did not differ from that of age-matched controls. Psychometric analysis of these data allowed us to generate a 10- item disease-specific instrument (DSI), which conveyed patient-based attitu des toward outcome.